Seizure (peds)

General

It is important to consider performing imaging in young patients with new-onset focal seizures to look for a brain mass or trauma

immed after trauma = impact sz (no antieleptics)

>20min after = TBI (antieleptic)

INH --> pyridoxine

Status epilepticus is a "prolonged" seizure or recurrent seizures lasting >5 minutes without the patient's regaining consciousness. Rapid cessation of status epilepticus is important to prevent irreversible neuronal damage

In children with a prolonged postictal state, especially in those who are not known to have had a prolonged postictal state with past epileptic episodes, consider the diagnosis of nonconvulsive status epilepticus.8 Consider an emergency EEG to identify seizure activity. If EEG testing is not available, a trial of anticonvulsants can be initiated and might result in improved mental status. Morbidity and mortality are increased when nonconvulsive status epilepticus is untreated, but less so than with untreated convulsive status epilepticus.8

Syncope

Breath-holding spells

Cataplexy

Narcolepsy

Vasovagal event

Standing for long periods of time

Standing quickly from laying or sitting

Hair-grooming syncope

Earring-changing syncope

Micturition syncope

Emotional distress or pain

Hypoglycemia

Hypovolemia

Sandifer syndrome (gastroesophageal reflux)

Acute life-threatening event

Acute dystonic reactions/drug reactions [i.e., promethazine (Phenergan)]

Movement disorders

Tics

Myoclonic jerks

Chills or rigors

Shudder attacks

Mannerisms

Self-stimulation

Choreoathetosis

Night terrors, sleep walking

Migraine variants

Benign paroxysmal vertigo

Nonepileptic paroxysmal event (pseudoseizure)